Whittaker A A, Albee B J
ANNA J. 1996 Aug;23(4):369-75; discussion 376-7.
To identify factors that influence selection of a dialysis treatment modality by patients with renal failure.
Qualitative, using grounded theory method.
SAMPLE/SETTING: Twenty subjects were selected from dialysis populations in urban and rural Nebraska and in Southern California. Theoretical sampling was used to guide subject selection.
Data gathered through interviews were taped and transcribed verbatim. Constant comparative analysis was used to identify patterns, develop categories, and guide further interviews.
A two-stage model was developed. The first stage contains the processes of valuing and evaluating perceived threats. During the second stage, weighing alternatives, individuals compare the benefits and concerns of each dialysis modality and choose the modality that maximally supports identified values and minimizes the number of threats.
The selection process is influenced by the presence or absence of basic resources, for example, quality and timing of information, prior placement of vascular access, and social and family support systems. Nurses can support the modality selection process by identifying and reducing threats and by enhancing or altering basic resources.
确定影响肾衰竭患者透析治疗方式选择的因素。
采用扎根理论方法的定性研究。
样本/地点：从内布拉斯加州城乡以及南加州的透析人群中选取了20名研究对象。采用理论抽样指导研究对象的选择。
通过访谈收集的数据进行录音并逐字转录。运用持续比较分析法来识别模式、形成类别并指导进一步访谈。
构建了一个两阶段模型。第一阶段包含重视和评估感知到的威胁的过程。在第二阶段，权衡替代方案时，个体比较每种透析方式的益处和问题，并选择能最大程度支持已确定价值观且将威胁数量降至最低的方式。
选择过程受到基本资源是否存在的影响，例如信息的质量和及时性、血管通路的预先安置以及社会和家庭支持系统。护士可以通过识别和减少威胁以及增强或改变基本资源来支持治疗方式的选择过程。
